Recurrent Pregnancy Loss

Causes & Risk Factors

Recurrent pregnancy loss can arise from several distinct categories of underlying cause, often requiring a structured, stepwise evaluation:

•  Chromosomal abnormalities — in either parent, or arising sporadically in the pregnancy itself, are among the most common identifiable causes.

•  Antiphospholipid syndrome (APS) — an autoimmune clotting disorder associated with pregnancy loss, particularly after the first trimester.

•  Endocrine and metabolic conditions — thyroid dysfunction and poorly controlled blood glucose can both contribute to pregnancy loss risk.

•  Anatomical factors — uterine structural abnormalities can affect the ability to carry a pregnancy to term.

•  Thrombophilia-related conditions — inherited or acquired clotting tendencies may play a role in selected cases.

•  Age — the risk of pregnancy loss, largely related to chromosomal factors, increases with advancing maternal age.

Symptoms & When to Test

Recurrent pregnancy loss is defined by the pattern of pregnancy outcomes rather than symptoms during a single pregnancy.

•  Two or more consecutive pregnancy losses

•  Pregnancy losses occurring at a similar gestational stage across multiple pregnancies

•  Pregnancy loss after the first trimester, which may raise suspicion for antiphospholipid syndrome

•  Known thyroid disorder, diabetes, or autoimmune condition with recurrent pregnancy loss

When Should You Consider Testing?

Evaluation is generally recommended after two consecutive pregnancy losses, or sooner if there is a known risk factor such as advanced maternal age, a prior late pregnancy loss, or a known autoimmune or endocrine condition.

Why Tests Are Combined

Because recurrent pregnancy loss can stem from chromosomal, autoimmune, endocrine, or anatomical causes, a single test cannot rule in or rule out all possibilities — parental karyotyping addresses genetic causes, while the antiphospholipid antibody panel addresses autoimmune clotting risk, and these operate through entirely different mechanisms.

Thyroid and metabolic testing (TSH, free T4, HbA1c) is included because both hypothyroidism and poorly controlled glucose are treatable contributors to pregnancy loss risk, making them worthwhile to screen even when not clinically obvious.

In selected cases, genetic testing of the pregnancy tissue itself (products of conception) can clarify whether a specific loss was due to a chromosomal abnormality in that pregnancy — distinct from testing the parents — and the choice between these approaches depends on clinical history and the treating specialist's advice.

Tests Available at NPL

Most reproductive hormone and genetic tests do not require fasting. However, some tests have specific timing requirements (such as a particular day of the menstrual cycle), and if other tests are ordered at the same time, fasting may be required for those investigations. Please follow the preparation and timing instructions provided by your doctor or NPL.

Home Sample Collection

NPL offers convenient home sample collection for Recurrent Pregnancy Loss blood tests, so you don't need to visit a lab in person.

→ Book your test online, via the NPL app, or by calling +977 1 5970147 and select a convenient time slot for home sample collection.

→ A certified and experienced NPL phlebotomist visits your home at the scheduled time, following strict hygiene and safety protocols.

→ Your sample is transported under controlled, monitored conditions to NPL's NABL ACCREDITED UNDER ISO 15189:2022 laboratory for processing.

→ Your digital report is delivered securely to your phone or email, along with access to download and share it as needed.

When to See a Doctor

•  Two or more consecutive pregnancy losses

•  Pregnancy loss occurring after the first trimester

•  Known autoimmune, thyroid, or metabolic condition with recurrent pregnancy loss

•  Family history of recurrent pregnancy loss or known genetic condition

•  Planning a future pregnancy after prior loss(es)